Effect of Iron Supplementation on Haemoglobin Response in Children: Systematic Review of Randomised Controlled Trials

Gera, Tarun; Sachdev, H. P. S.; Nestel, Penelope; Sachdev, Sudeep Singh

doi:10.1097/01.mpg.0000243440.85452.38

Cited by 104 publications

(82 citation statements)

References 81 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In a previously conducted meta-analysis (6) , the pooled estimate (random effects model) from fifty-six trials for the change in Hb concentration following Fe supplementation v. placebo (WMD) was 0?74 g/dl (95 % CI 0?61, Unless specified separately, the number of analytic components is 33. In the multivariate model, the number of analytic components is 32 and the proportion of residual variation due to heterogeneity (I 2 ) is 0?75.…”

Section: Discussionmentioning

confidence: 99%

Effect of combining multiple micronutrients with iron supplementation on Hb response in children: systematic review of randomized controlled trials

Gera

Sachdev

Nestel

2009

Public Health Nutr.

Self Cite

View full text Add to dashboard Cite

Objectives: To study the effect of combining multiple (two or more) micronutrients with Fe supplementation on Hb response, when compared with placebo and with Fe supplementation, in children. Data sources: Electronic databases, personal files, hand search of reviews, bibliographies of books, and abstracts and proceedings of international conferences. Review methods: Randomized controlled trials evaluating change in Hb levels with interventions that included Fe and multiple-micronutrient supplementation in comparison to placebo alone or Fe alone were analysed in two systematic reviews. Results: Twenty-five trials were included in the review comparing Fe and micronutrient supplementation with placebo. The pooled estimate (random effects model) for change in Hb with Fe and micronutrient supplementation (weighted mean difference) was 0?65 g/dl (95 % CI 0?50, 0?80, P , 0?001). Lower baseline Hb, lower height-for-age Z score, non-intake of 'other micronutrients' and malarial non-hyperendemic region were significant predictors of greater Hb response and heterogeneity. Thirteen trials were included in the review comparing Fe and micronutrient supplementation with Fe alone. The pooled estimate for change in Hb with Fe and micronutrient supplementation (weighted mean difference) was 0?14 g/ dl (95 % CI 0?00, 0?28, P 5 0?04). None of the variables were found to be significant predictors of Hb response. Conclusions: Synthesized evidence indicates that addition of multiple micronutrients to Fe supplementation may only marginally improve Hb response compared with Fe supplementation alone. However, addition of 'other micronutrients' may have a negative effect. Routine addition of unselected multiple micronutrients to Fe therefore appears unjustified for nutritional anaemia control programmes.

show abstract

Section: Discussionmentioning

confidence: 99%

Effect of combining multiple micronutrients with iron supplementation on Hb response in children: systematic review of randomized controlled trials

Gera

Sachdev

Nestel

2009

Public Health Nutr.

Self Cite

View full text Add to dashboard Cite

show abstract

“…Various units in WHO had produced the documents including units dealing with child and adolescent health, nutrition, blood transfusion safety and soil-transmitted helminths. The documents included guidelines and recommendations, expert opinions/consultations and statements (2,5,6) . The target audience (e.g.…”

Section: Analysis Of International Anaemia Policies Relevant For Afrimentioning

confidence: 99%

Implications of inconsistent anaemia policies for children and adolescents in Africa

Hamdan

Brabin

Bates

2013

Public Health Nutr.

View full text Add to dashboard Cite

Objective: To evaluate the quality of policies concerning the diagnosis, treatment and prevention of anaemia in children and adolescents; to determine to what extent these are evidence-based; and to use this analysis to inform the policymaking process. Subjects: Children and adolescents in sub-Saharan Africa. Setting: Almost 50 % of children and adolescents in sub-Saharan Africa are anaemic, which has profound effects on their intellectual and physical development and their chance of survival. Evidence-based policies are essential to reduce anaemia but because it is caused by an array of interdependent factors, developing policies is challenging. Design: Forty-six policy documents concerning the diagnosis, treatment and prevention of anaemia in children and adolescents were identified and analysed. Results: There was policy consensus on the usefulness of Fe supplements, the need to treat co-morbidities and the use of blood transfusions for severe anaemia. Information about diagnosis was scarce, and messages regarding the control of anaemia were mixed. Few of the policies were tailored for the African context and they were located on several websites hosted by different health programmes. Conclusions: The weakest aspects of the policies and consequently the priorities for better policy making were: lack of adherence to WHO recommendations for guideline development; little involvement of African practitioners/policy makers in the guideline group and as peer reviewers; and lack of harmonisation, demonstrating the need to establish a single body responsible for developing/ revising anaemia policies.

show abstract

“…Iron supplements are recommended both to treat and prevent iron deficiency anaemia in 64 populations at risk, particularly pregnant women and young children in communities where diets are inadequate (1)(2) . Most iron supplement trials have targeted pre-school children since 66 they undergo rapid growth and often consume a diet containing little iron (2) .…”

Section: Introductionmentioning

confidence: 99%

“…The benefits of daily or intermittent iron treatment have been widely debated (22)(23)(24) . However, a 276 systematic review of 55 studies concluded overall that iron supplements were effective in increasing haemoglobin concentration in children irrespective of the frequency of treatment 278 (1) . Current recommendations advise once-weekly iron supplements for three months on the basis that this regimen is associated with a low risk of side effects and greater compliance 280 than more frequent doses (6,13) .…”

mentioning

confidence: 99%

See 1 more Smart Citation

The effect of a school-based iron intervention on the haemoglobin concentration of school children in north-west Pakistan

Rousham

Uzaman²,

Abbott

et al. 2013

Eur J Clin Nutr

View full text Add to dashboard Cite

Effect of Iron Supplementation on Haemoglobin Response in Children: Systematic Review of Randomised Controlled Trials

Cited by 104 publications

References 81 publications

Effect of combining multiple micronutrients with iron supplementation on Hb response in children: systematic review of randomized controlled trials

Effect of combining multiple micronutrients with iron supplementation on Hb response in children: systematic review of randomized controlled trials

Implications of inconsistent anaemia policies for children and adolescents in Africa

The effect of a school-based iron intervention on the haemoglobin concentration of school children in north-west Pakistan

Contact Info

Product

Resources

About